Incidents with virus would force State health officials to apply new requirements to hospitals

By Howard Fischer
Capitol Media Services
Published/Last Modified on Wednesday, October 31, 2007 3:06 PM MDT


PHOENIX — The state’s top health official is weighing whether to force hospitals to disclose how often patients get infections, including from the new “superbug’’ virus.


 Health Director Susan Gerard said more than half of other states have some sort of requirements for hospitals to report various problems that develop with patients. And she said the issue has taken on new life in the wake of incidents with new strains of virus which do not respond to traditional treatments, most notably methicillin-resistant staphylococcus aureus.

 But Gerard told Capitol Media Services Tuesday she’s not convinced that whatever her agency forces hospitals to provide to her agency should be made available to would-be patients — or even helps the primary goal of patient safety.

 She said most patients don’t get to choose where they are hospitalized. And Gerard said even those who do probably wouldn’t look up the information ahead of time.

 Any plan to make this kind of info public will get scrutiny — and possible opposition — from the Arizona Hospital and Healthcare Association. “We understand the public concern over MRSA and other infections that are out there,’’ said John Rivers president of the organization. “We understand our need to respond to it responsibly and professionally.’’

 Rivers said, though, there is a fear hospitals might be tagged with infections that are not their fault. “It’s very, very difficult to know whether the patient got that infection while he or she was in the hospital, whether it was brought into the hospital by that patient, whether the patient got the infection from a family member or other person outside the institution,’’ he said.

 But Gerard said that, at least with MRSA, that’s not an issue.

 She said “community acquired MRSA’’ usually shows up as a skin infection. “A hospital-acquired one kind of gets into your bone, into your blood system, into your organs,’’ she said. Gerard said while “it’s still the same superbug’’ it is a “totally different kind of infection.’’

 The state Department of Health Services is sending detailed information about the bug to health care providers.

 According to health officials, MRSA infections occur most frequently among those in hospitals and nursing homes as well as those at dialysis facilities. But Gerard said she’s not convinced that public release of each institution’s infection data would be useful — or that it would lead to more informed choices.

 “If you’re in a car accident you don’t usually get to choose where you’re going,’’ she said. “And then there’s a whole lot of others of us who don’t get to choose where we’re going because our insurance company dictates where we can go.’’

 That assumes people who have a choice actually seek outinformation.

 Gerard said she’s found that people usually don’t look up information already publicly available about their doctors until after they’ve had a “bad outcome.’’ She said that type of attitude is not unusual, saying the same thing occurs at the

 Registrar of Contractors where queries are made only after the roof starts to leak.

 She also said a facility which treats many burn victims — people easily susceptible to infection — is more likely to show a higher rate than a community hospital dealing mostly with auto accidents.

 The discussion of new regulations comes as the agency issued new

guidelines Tuesday designed to help people prevent that “community acquired’’ disease — and to prevent public panic in the wake of at least one death in New York city earlier this month.

 Rebecca Sunenshine, deputy state epidemiologist, said the virus is spread primarily by touching others who already are infected.

 She said that makes things like regular hand washing with soap or hand sanitizer “essential in facilities where people work, live and play close together.’’

 The state has sent information to school administrators about the disease, including how routine cleaning procedures should be enough to help keep it from spreading. The advisory also said students who have skin infections with MRSA can attend school “as long as the wound is covered with a clean, dry dressing and they are receiving proper treatment.’’

 Ways to prevent the spread of MRSA and other staph infections:

 - Wash hands regularly with soap or sanitizer.

 - Keep cuts and scrapes covered with a clean, dry bandage.

 - Don’t touch other people’s wounds or bandages.

 - Don’t share personal items such as towels, wash cloths, bar

 soap or razors.

 - Don’t share sports equipment. If equipment is shared, wear

 clothing underneath. Clean equipment and mats before and after

 use.

 - Avoid unnecessary antibiotics.

 — Source: Arizona Department of Health Services

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